Provider Demographics
NPI:1588112890
Name:SAUL, RACHEL EVORA (LMSW)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:EVORA
Last Name:SAUL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6830 DEWEESE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-9562
Mailing Address - Country:US
Mailing Address - Phone:989-292-0564
Mailing Address - Fax:
Practice Address - Street 1:4205 CHARLAR DR
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-6810
Practice Address - Country:US
Practice Address - Phone:989-292-0564
Practice Address - Fax:517-367-0681
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011039771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical